International Journal of Clinical Practice最新文献

{"title":"Genetic Predictive Association Between Inflammatory Cytokines and Vitiligo: A Bidirectional Mendelian Randomization Study","authors":"Tianbing Lei,&nbsp;Yao Ni","doi":"10.1155/ijcp/1093015","DOIUrl":"https://doi.org/10.1155/ijcp/1093015","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Previous studies have indicated a close association between vitiligo and inflammatory cytokines, yet the genetic predictive association remains unclear. The study aimed to predict the relationship between vitiligo and inflammatory cytokines in genetics.</p>\u0000 <p><b>Methods:</b> A bidirectional analysis was conducted by the two-sample MR. We selected independent genetic tools for significant levels associated with inflammatory cytokines and vitiligo from corresponding meta-analyses of genome-wide association study (GWAS). The summary data for inflammatory cytokines were derived from a GWAS meta-analysis conducted on three separate Finnish population cohorts, comprising a total of 8293 individuals (<i>N</i> = 8293). The vitiligo data, on the other hand, were extracted from a GWAS meta-analysis conducted on individuals of European ancestry, totaling 44,266 individuals (<i>N</i> = 44,266). As the primary analytical approach, we employed the inverse variance weighted (IVW) method, and to ensure the reliability of our main findings, we also performed sensitivity analysis to evaluate the robustness.</p>\u0000 <p><b>Results:</b> Compelling evidence indicated a causal association between genetically predicted IL-18 and IL-8 with vitiligo (odds ratio, OR: 1.162, 95% CI: 1.043–1.295, <i>p</i> = 0.006, and <i>p</i>_fdr = 0.020 and OR: 0.726, 95% CI: 0.602–0.876, <i>p</i> = 0.001, and <i>p</i>_fdr = 0.004). In addition, cytokines including stromal cell-derived factor-1 alpha (SDF1a) (Beta: 0.032, <i>p</i> = 0.016, and <i>p</i>_fdr = 0.039), IL-17 (Beta: 0.038, <i>p</i> = 0.005, and <i>p</i>_fdr = 0.027), basic fibroblast growth factor (FGFBasic) (Beta: 0.028, <i>p</i> = 0.034, and <i>p</i>_fdr = 0.170), monocyte chemoattractant protein-1(MCP1) (Beta: 0.026, <i>p</i> = 0.046, and <i>p</i>_fdr = 0.189), and platelet-derived growth factor BB (PDGFbb) (Beta: 0.026, <i>p</i> = 0.040, and <i>p</i>_fdr = 0.198) were suggested to be the consequences of vitiligo.</p>\u0000 <p><b>Conclusions:</b> According to this investigation, it has been proposed that the etiology of vitiligo is likely associated with IL-18 and IL-8, whereas the downstream progression of vitiligo can be attributed to several inflammatory cytokines such as IL-17, SDF1a, PDGFbb, MCP1, and FGFBasic.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1093015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 3D Printing Technology and Artificial Intelligence Assisted in Total Knee Arthroplasty","authors":"Jingbo Pan,&nbsp;Qi Zhang,&nbsp;Gang Kong,&nbsp;Dan Liu,&nbsp;Xiujiang Sun,&nbsp;Guodong Zhang,&nbsp;Yue Zou,&nbsp;Kegui Liu","doi":"10.1155/ijcp/8793065","DOIUrl":"https://doi.org/10.1155/ijcp/8793065","url":null,"abstract":"<div>\u0000 <p>This study aimed to evaluate the efficacy of personalized 3D printing osteotomy guides and artificial intelligence (AI)-assisted surgical planning in total knee arthroplasty (TKA). A cohort of 60 cases was randomly allocated into two groups: one receiving assistance from personalized 3D printing osteotomy guides and the other benefiting from AI-assisted surgical planning for the procedure. We compared surgical duration, intraoperative bleeding, postoperative incision drainage, length of hospital stay, surgical accuracy, and postoperative visual analog scale (VAS) and Hospital for Special Surgery (HSS) outcomes between the two groups. Continuous data conforming to a normal distribution were analyzed using independent-samples <i>t</i>-tests, while categorical data were assessed with chi-square tests. The findings of our study indicated that the 3D printing-assisted TKA (3D-TKA) group experienced significant lower levels (<i>p</i> &lt; 0.05) of bleeding and drainage (160.1 ± 24.3 mL, 199.5 ± 29.6 mL) compared to the AI-assisted TKA (AI-TKA) group (174.7 ± 25.7 mL, 223.8 ± 29.2 mL). Furthermore, the duration of surgery and hospital stay (81.4 ± 8.9 min, 7.7 ± 1.3 day) was significantly longer (<i>p</i> &lt; 0.05) in the 3D-TKA group than the AI-TKA group (72.9 ± 10.0 min, 6.8 ± 1.6 day). No significant differences (<i>p</i> &gt; 0.05) were observed in surgical accuracy between the two groups. On the first day postoperation, VAS scores were significantly lower (<i>p</i> = 0.001) in the 3D-TKA group. In summary, each surgical approach offers distinct benefits. 3D printing primarily enhances patient outcomes, whereas AI assistance tends to favor surgical efficiency.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8793065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Correlation Between Renal Function Markers and Serum Ferritin Levels in Thalassemia Patients","authors":"Mohammad Tammadondar,&nbsp;Ali Vatankhah,&nbsp;Niloufar Khatibzade-Nasari","doi":"10.1155/ijcp/6915906","DOIUrl":"https://doi.org/10.1155/ijcp/6915906","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> This study aimed to analyze renal function markers and correlate the results with serum ferritin levels in patients with thalassemia in Bandar Abbas, Iran, in 2020.</p>\u0000 <p><b>Method:</b> A cross-sectional study was conducted, and patients with a proven hemoglobinopathy diagnosis were included. Fasting blood was obtained to measure creatinine, sodium, potassium, calcium, phosphorus, magnesium, uric acid, and ferritin. In addition, a 24-h urine specimen was collected to determine the level of urine albumin, creatinine, sodium, potassium, calcium, phosphorus, magnesium, uric acid, and β2-microglobulin. Fractional excretion of sodium, potassium, calcium, phosphorus, magnesium, and uric acid was also calculated. Spearman’s coefficient of correlation was used to determine the correlations between serum ferritin level and other variables.</p>\u0000 <p><b>Results:</b> Of the sixty-six patients studied, 3.0% had sickle cell thalassemia, 80.3% had major thalassemia, and 72.7% had intermediate thalassemia. In our study, serum ferritin, 24-h urine protein, and fractional excretion of sodium, calcium, and urine were higher than the normal range in thalassemia patients. There was a significant correlation between serum ferritin level and fractional excretion of magnesium, calcium, sodium, phosphorus, and uric acid with a negative correlation coefficient (<i>p</i> ≤ 0.05). We also found that the serum ferritin levels strongly correlated with microalbuminuria (<i>p</i> ≤ 0.05).</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6915906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Diet With High Phosphatemic Index With Odds of Nonalcoholic Fatty Liver Disease","authors":"Mitra Kazemi Jahromi,&nbsp;Mostafa Norouzzadeh,&nbsp;Farshad Teymoori,&nbsp;Niloufar Saber,&nbsp;Hamid Ahmadirad,&nbsp;Hossein Farhadnejad,&nbsp;Ammar Salehi-Sahlabadi,&nbsp;Parvin Mirmiran","doi":"10.1155/ijcp/4066662","DOIUrl":"https://doi.org/10.1155/ijcp/4066662","url":null,"abstract":"<div>\u0000 <p><b>Aim:</b> A high intake of dietary phosphorus with an effect on the serum phosphorus level may affect the health status and predict the occurrence of some clinical disorders. Therefore, in the current study, we aimed to determine phosphatemic index (PI) according to serum levels of phosphorus after intake of different foods and assess its association with the odds of nonalcoholic fatty liver disease (NAFLD).</p>\u0000 <p><b>Methods:</b> The current study was conducted with case-control design on 225 newly diagnosed NAFLD cases and 450 controls aged 20–60 years. Dietary intake data were collected by a validated food frequency questionnaire. The PI was calculated as the area under the curve (AUC) of serum phosphorus after eating test food divided by the AUC for the food supply containing an equal quantity of phosphorus. Multivariable logistic regression models were used to evaluate the NAFLD odds according to tertiles of the PI score.</p>\u0000 <p><b>Results:</b> The median (IQR) of dietary PI in participants of case and control groups was 83.9 (55.8–114.2) and 82.1 (52.6–119.6), respectively. In the age and sex-adjusted model, there was no statistically significant association between PI and the odds of NAFLD (OR = 1.47; 95% CI: 0.98–2.19, <i>P</i>_trend = 0.065). However, in fully adjusted model, after controlling the effects of age, sex, waist-to-hip ratio, smoking, dietary intake of energy, dietary fiber, physical activity, and socioeconomic status, the odds of NAFLD increased across tertiles of PI (OR = 1.97; 95% CI: 1.08–3.58, <i>P</i>_trend = 0.028).</p>\u0000 <p><b>Conclusions:</b> Our results suggested that a diet with a higher PI score may contribute to an increase in the odds of NAFLD independent of common confounders.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4066662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Vaccine Hesitancy Levels Among Turkish Parents in 2024 After Pandemic; Key Influencing Factors: A Cross-Sectional Study","authors":"Zehra Kılınç,&nbsp;Songül Beycur Işık","doi":"10.1155/ijcp/5511192","DOIUrl":"https://doi.org/10.1155/ijcp/5511192","url":null,"abstract":"&lt;div&gt;\u0000 &lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; This study aimed to evaluate the level of vaccine hesitancy and related factors regarding childhood vaccines among parents with children under 5 years of age receiving services from a health center in Turkey.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Materials and Methods:&lt;/b&gt; This cross-sectional study was conducted with parents with children under 5 years of age who applied to a primary care family health center in Diyarbakır province between 1 November and 1 December 2023. The number of children under 5 years of age registered at the family health center was approximately 800, and the minimum sample size was calculated as 219 using the Open Epi program with a 13% vaccine hesitancy frequency, 99% confidence interval, and 80% power. A total of 214 parents who had no communication problems and voluntarily agreed to participate were included in the study. Data were collected through face-to-face interviews using a data form including demographic information of parents and their children, vaccination knowledge, the impact of the COVID-19 pandemic on vaccination attitudes, and the Parents’ Attitudes Toward Childhood Vaccines Scale (PACV) Scale. Data were analyzed using SPSS (Version 24.0).&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Findings:&lt;/b&gt; The mean age of the participants was 32.2 ± 5.9 years, 73.4% were mothers, 70.1% and 62.6% of their spouses had high school education or less, and 60.7% were not employed. A total of 65.9% of the parents were at the middle-income level and 76.6% stated that they had sufficient knowledge about child vaccines. They mostly received vaccine information from family health center nurses or physicians (84.1%). The vaccine hesitation rate was 16.8% and the PACV Scale’s mean score was 34.38 ± 15.60. No significant difference was found between the hesitation levels of the parents. While the rate of hesitation was 36.1% in parents with sufficient knowledge about vaccination, this rate was 63.9% in those with insufficient knowledge, and this difference was found to be statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.01). In addition, vaccine hesitancy was found to be higher in parents who did not have a negative impact of the COVID-19 pandemic on the vaccination decision. Parents with university and higher education level had higher and statistically significant safety-effectiveness scale subdimension scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; In this study, vaccine hesitation was found in 16.8% of the parents and the level of hesitation was found to be associated with knowledge and education levels. The hesitation rate was found to be lower in parents who had sufficient knowledge about childhood vaccines. The higher hesitation levels of parents who reported that the pandemic did not negatively affect their vaccination decisions suggest the effect of social and psychological factors. The findings emphasize the importance of education and awareness-raising activities for parents to reduce vaccine hesitanc","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5511192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143110998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep-Breath–Related Characteristics in Males With Chronic Rhinosinusitis","authors":"Wenjun Xue,&nbsp;Qianqian Zhang,&nbsp;Xiaolin Wu,&nbsp;Huaming Zhu,&nbsp;Xinyi Li,&nbsp;Yunhai Feng,&nbsp;Haibo Ye","doi":"10.1155/ijcp/3662245","DOIUrl":"https://doi.org/10.1155/ijcp/3662245","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Patients with chronic rhinosinusitis (CRS) often exhibit sleep impairments that are closely associated with obstructive sleep apnea (OSA). However, objective evaluations of sleep quality in inpatients with CRS are lacking. This study explored the sleep-breath–related characteristics of CRS patients without nasal polyps (CRSsNP).</p>\u0000 <p><b>Methods:</b> In this cross-sectional single-center study, we recruited 147 adult male inpatients diagnosed with CRSsNP between March 2019 and April 2020. OSA was diagnosed using standard PSG. The patients were classified into two groups based on the apnea–hypopnea index: CRSsNP with OSA and CRSsNP without OSA groups. Demographic features and sleep parameters were evaluated and compared between the groups.</p>\u0000 <p><b>Results:</b> Inpatients with CRSsNP were at high risk of OSA (61.2%). Interestingly, the oxygen desaturation index (ODI), sleep efficiency (SE), and wake duration showed no differences between the CRSsNP with OSA and CRSsNP without OSA patients. The CRSsNP with OSA group exhibited a higher prevalence of obesity, slept for less time, was more easily aroused, and exhibited higher SE and larger CT90 scores during sleep (<i>p</i> &lt; 0.05) compared to the CRSsNP without OSA group. Linear regression analysis revealed that the average SpO₂ value (<i>β</i> = 1.182; <i>p</i> = 0.036) and ODI (<i>β</i> = 0.818; <i>p</i> &lt; 0.001) remained significantly associated with OSA in CRS patients even after adjusting for age and body mass index.</p>\u0000 <p><b>Conclusions:</b> Male inpatients with CRSsNP exhibited a high prevalence of OSA. CRSsNP patients evidenced severe hypoxia and exhibited more awakenings during sleep.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3662245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143110669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Silymarin on Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Mahdi Vajdi,&nbsp;Shaghayegh Adeli,&nbsp;Arash Karimi,&nbsp;Vahid Asghariazar,&nbsp;Arezoo Moini Jazani,&nbsp;Ramin Nasimidoost Azgomi","doi":"10.1155/ijcp/3985207","DOIUrl":"https://doi.org/10.1155/ijcp/3985207","url":null,"abstract":"<div>\u0000 <p>Numerous studies have investigated into the antioxidant and anti-inflammatory properties of silymarin, as well as its ability to reduce reactive oxygen species and inflammation biomarkers. The effect of silymarin on inflammation and oxidative stress was investigated using the keywords “milk thistle” OR “Silybum marianum” OR “Silybum” OR “silymarin” OR “Silibinin” AND “MDA” OR “Malondialdehyde” OR “TAC” OR “total antioxidant capacity” OR “IL-10” OR “Interleukin-10” OR “IL-6” OR “Interleukin-6” OR “TNF-α” OR “tumor necrosis factor alpha” on the Web of Science, Scopus, Embase, PubMed, and Cochrane Library, up until March 2023. Data were combined using a random-effects model, and the weighted/standardized mean differences (WMDs/SMDs) with a 95% confidence interval (CI) were used as the overall effect size. Our meta-analysis indicated that silymarin supplementation resulted in a significant decrease in levels of C-reactive protein (CRP) (WMD: −3.39 mg/L, 95% CI: −5.99, −0.79, <i>p</i> = 0.01) and malondialdehyde (MDA) (SMD: −1.69, 95% CI: −2.62, −0.76, <i>p</i> &lt; 0.001). Furthermore, silymarin significantly increases IL-10 (WMD: 2.03 pg/mL; 95% CI: 1.04, 3.01, <i>p</i> &lt; 0.001), superoxide dismutase (SOD) (SMD: 3.39, 95% CI: 1.42, 5.37, <i>p</i> = 0.001), and glutathione peroxidase (GPx) (SMD: 1.94; 95% CI, 0.89 to 2.99; <i>p</i> &lt; 0.001) level. However, silymarin supplementation did not have significant effects on TAC (SMD: 2.91; 95% CI: −0.30, 6.11, <i>p</i> = 0.076) and IL-6 (WMD: −0.70 pg/mL; 95% CI: −1.42, 0.02, <i>p</i> &lt; 0.056) level. Silymarin supplementation may significantly improve oxidative stress and inflammation in adults by decreasing CRP and MDA and increasing IL-10, SOD, and GPx. However, additional studies with longer study periods are required to ascertain the long-term effects of silymarin on oxidative stress and chronic inflammation.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3985207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143118189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Subtypes and Prognostic Outcomes of Rhabdomyolysis in ICU Patients","authors":"Shan Xu,&nbsp;Kaixiu Qin,&nbsp;Dan Zhang","doi":"10.1155/ijcp/3392487","DOIUrl":"https://doi.org/10.1155/ijcp/3392487","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Rhabdomyolysis (RM) is a severe clinical syndrome with substantial heterogeneity that involves the rapid dissolution of skeletal muscles. The condition has a high prevalence and poor prognosis, particularly in critically ill patients. Subtypes of RM in critically ill patients have not been investigated.</p>\u0000 <p><b>Objective:</b> The study aimed to link the clinical RM heterogeneity with distinct prognoses and associated characteristics among different subtypes using an unsupervised analysis.</p>\u0000 <p><b>Methods:</b> Patients diagnosed with RM in the intensive care unit (ICU) from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and the eICU Collaborative Research Database (eICU) were retrospectively enrolled. K-means clustering, guided by correlation coefficients and expert opinions in intensive care medicine, was applied to identify distinct RM clinical subtypes using routinely available parameters from the first 24 h after patient ICU admission. The primary endpoint was 28-day mortality. We assessed associations between subtypes and 28-day mortality, as well as between treatments and 28-day mortality in the derived subtypes, using multivariate Cox proportional hazards regression. The eICU database patients served as an external validation set. The SHapley Additive exPlanations (SHAPs) were used to visualize features of each clinical subtype.</p>\u0000 <p><b>Results:</b> A total of 2269 eligible subjects were extracted from the MIMIC-IV. Two distinct subtypes were identified (A and B) using 17 readily available clinical and biological variables. Patients assigned to Subtype A (<i>n</i> = 511) had a higher 28-day mortality. The proportion of organ support, comorbidity index, SAPS II, and SOFA scores were all significantly higher in the Subtype A group than in the Subtype B group (<i>n</i> = 1836). After adjusting for relevant covariates, Subtype A patients were independently associated with increased 28-day mortality (HR [95% CI] = 1.70 [1.36–2.11], <i>p</i> &lt; 0.001). These findings were further validated using an external cohort from the eICU dataset. Notably, Subtype A patients showed a higher mortality risk associated with sodium bicarbonate use (HR [95% CI] 1.62 [1.20–2.19], <i>p</i> = 0.002).</p>\u0000 <p><b>Conclusions:</b> We identified two subtypes with distinct clinical features and outcomes. Subtype A is independently associated with poor outcomes and shows increased mortality risk with sodium bicarbonate use. These findings may help clinicians better distinguish prognoses and treatment responses among RM patients.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3392487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143117424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Community Pharmacists’ Knowledge, Attitudes, and Practices Regarding Biosimilar Drugs: A Cross-Sectional Survey","authors":"Anan S. Jarab,&nbsp;Walid Al-Qerem,&nbsp;Karem H. Alzoubi,&nbsp;Shrouq R. Abu Heshmeh,&nbsp;Yazid N. Al Hamarneh,&nbsp;Eman Alefishat,&nbsp;Salahdein Aburuz","doi":"10.1155/ijcp/2248512","DOIUrl":"https://doi.org/10.1155/ijcp/2248512","url":null,"abstract":"&lt;div&gt;\u0000 &lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Understanding pharmacists’ knowledge, attitudes, and practices towards biosimilar therapy and exploring the potential barriers are a preliminary step in the road to the adoption of biosimilar therapy in community pharmacy and clinical practice.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; The aim of current study was to evaluate pharmacists’ understanding, investigate the factors that shape their attitudes and practices regarding biosimilar therapy, and identify the barriers to utilizing biosimilars in community pharmacies.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; A validated self-administered survey was disseminated in person to community pharmacists in different geographical regions of the UAE. Eligible participants were individuals who graduated from universities recognized by the UAE Ministry of Higher Education and were registered as community pharmacists in the UAE. The questionnaire included five sections that evaluated sociodemographic characteristics, knowledge and attitudes with respect to biosimilar therapy, the extent of its utilization, and the potential barriers that may limit the use of this therapy in community pharmacy settings. A quantile regression analysis was performed to explore the variables associated with pharmacists’ attitudes and practices regarding biosimilar therapy.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; The study included 504 pharmacists. The [median (IQR)] scores revealed a window for knowledge improvement [3 (1–5)] out of a maximum possible score of 8, unfavourable attitude [25 (22–30)] out of a maximum possible score of 40 and inadequate practice [27 (24–30) out of a maximum possible score of 45] concerning biosimilar utilization in clinical practice. The most commonly reported barriers to considering biosimilar therapy were lack of experience (40.67%), insufficient knowledge (40.47%) and lack of confidence (36.70%). Female pharmacists and those who had a B Pharm degree or used Lexicomp as an information source reported higher attitude scores. Moreover, pharmacists in charge or employee pharmacists, and those who had more than 10 years of experience and higher knowledge levels, reported improved attitude scores. However, pharmacists who dispensed less than 10 prescriptions per day, and those who reported lower knowledge and/or attitude scores exhibited lower practice levels.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The current study revealed a lack of knowledge, unfavourable attitudes and insufficient practices related to biosimilar therapy among community pharmacists, along with several identified barriers. Future efforts should focus on comprehensive educational programs that deliver up-to-date clinical information and emphasize the benefits of biosimilar drugs, specifically targeting male pharmacists, those with postgraduate degrees, pharmacy owners, pharmacists with less work experience, and those who dispense fewer prescriptions per day. These interventions are essential for enhancing pha","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/2248512","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143115509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assessment of Clinical Practice Guidelines for the Management and Surgical Treatment of Female Stress Urinary Incontinence","authors":"Mario Vásquez-Peralta,&nbsp;Alison Simancas-Racines,&nbsp;Juan Marcos Parise-Vasco,&nbsp;Camila Montesinos-Guevara,&nbsp;Daniel Simancas-Racines","doi":"10.1155/ijcp/3803266","DOIUrl":"https://doi.org/10.1155/ijcp/3803266","url":null,"abstract":"<div>\u0000 <p>Clinical practice guidelines (CPGs) are tools developed to support evidence-based decision making in healthcare. However, despite the availability of CPGs for the surgical management of female stress urinary incontinence (FSUI), their methodological quality has not been evaluated. The aim of this study was to assess the methodological quality of published guidelines for the surgical management of FSUI using the AGREE II tool. A systematic search of CPGs published between 2017 and 2023 was performed in databases including MEDLINE/PubMed, LILACS, Scopus, and Trip Medical Database. Data extraction and guideline selection were performed independently by two reviewers, as was the assessment using the AGREE II instrument. Of 1459 initial records, six guidelines met the eligibility criteria. The scores for each domain evaluated were as follows: scope and purpose (45.83%; SD: 22.69), stakeholder participation (30.56%; SD: 29.03), development (48.56%; SD: 30.42), presentation clarity (58.80%; SD: 22.25), applicability (24.04%; SD: 26.36), and editorial independence (44.87%; SD: 32.88). One of the six included CPGs was rated as high quality and recommended for clinical practice. Three CPGs with modifications were recommended because there were still areas that needed improvement to enhance their quality, and two CPGs were not recommended for clinical practice because the six domains evaluated scored below 60%. According to these findings, it is essential that new CPGs developed for the surgical management of FSUI adhere to greater methodological rigor to ensure that recommendations are based on the best available evidence. Furthermore, guidelines should take into account patient values and clinical expertise to improve and facilitate effective healthcare decision making.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3803266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143113643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}